Rheumatoid Arthritis, Osteoporosis, and Diet

What You Eat Affects Your Joints and Bones

Peer Reviewed

Osteoporosis is connected to rheumatoid arthritis? Is that true? Perhaps "connected" isn't the best way to think of this, but it is true that 15% to 20% of patients with rheumatoid arthritis develop osteoporosis at the hip and spine.1 This isn't saying that if you have RA, you will develop osteoporosis, but if you have RA, you should be aware of what you can do to take good care of your bones—including watching what you eat.

Normal bone versus bone affected by osteoporosis

A study done in 2009 by researchers in Brazil looked at the association between osteoporosis and rheumatoid arthritis in women. They found that for those women, certain nutritional factors and body composition make a difference in how strong their bones are. This article will focus on the nutritional factors to help you decide if you should modify your diet because you have rheumatoid arthritis.

How Rheumatoid Arthritis Affects Bone Mass
Throughout your life, your body is breaking down and creating new bones. You can learn more about this process in our article that explains bone health. As you grow older, bone production slows down, and some people may develop osteoporosis, or weakened bones that are prone to fracture.

Rheumatoid arthritis and the way it affects your body can also impact your bone mass, perhaps making you more at risk for osteoporosis. For example, corticosteroids are often part of a rheumatoid arthritis treatment plan. They reduce inflammation, as you can read in this article on drugs and medications for rheumatoid arthritis.

However, corticosteroids can decrease bone mass, as explained in our article on osteoporosis causes.

There are other possible RA-osteoporosis connections, including how people with RA find it harder to exercise—and exercise is something that can help keep your bones strong, even as you age.

Diet, Rheumatoid Arthritis, and Osteoporosis
The Brazilian study looked at the diets of women with rheumatoid arthritis. They analyzed total daily intake of calcium, vitamin D, and the polyunsaturated acids omega-6 and omega-3.

As you may know, calcium and vitamin D play a role in maintaining healthy bones. Omega-6 and omega-3 also influence the bone maintenance process; omega-3, for example, helps your body absorb calcium, which is necessary for bone health.

Additionally, omega-6 and omega-3 are important in rheumatoid arthritis (read our article on the omega-6 and omega-3 ratio in RA diets). You must maintain a healthy ratio of omega-6 and omega-3 in your diet: too much omega-6 and too little omega-3 can increase your inflammation.

A diet heavy in omega-6 fatty acids has been shown to lead to lower bone mineral density1—so you can see that if you have rheumatoid arthritis and want to protect your bones, you should monitor your omega-6 and omega-3 intake.

The study in Brazil found that the patients who had a higher omega-6 to omega-3 ratio had lower bone density—making them more prone to osteoporosis and osteoporosis-caused fractures.

What Does this RA Study Mean for You?
The study—and you can read the full study and article for yourself by following the link at the end of this article—has a lot more to say about factors that influence osteoporosis. However, when it comes to diet, you can take away this: make sure your omega-6 to omega-3 ratio is between 2:1 and 3:1. You can work with a nutritionist or a registered dietitian to establish a good meal plan that will help your rheumatoid arthritis—and take good care of your bones.

Updated on: 06/12/15
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Floranne Ernste, MD
This article was reviewed by Floranne Ernste, MD.
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